Test Bank for Dewitt’s Medical Surgical Nursing Concepts and Practice 4th Edition Stromberg / All Chapters 1-49 / Full Complete 2023

Chapter 01:Caring for Medical-Surgical Patients
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deWit: Medical-Surgical Nursing: Concepts & Practice, 5th Edition
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MULTIPLECHOICE

Whichstatementaccuratelydescribestheprimarypurposeofthestatenursepracticeact
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(NPA)?
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a. TotestandlicenseLPN/LVNs. m m m m




b. TodefinethescopeofLPN/LVN
practice. m




c. Toimprovethequalityofcare
provided by the LPN/LVN. m m m m




d. To limittheLPN/LVNemployment b m




placement. m




ANS: B m




While improving quality of care provided by the LPN/LVN may be a result of the NPA,
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the primary purpose of the NPA of each state defines the scope of nursing practice in that
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state.
m




CognitiveLevel:Comprehension
PTS: 1 DIF: m




REF: 2 m




OBJ:3 TOP: NPAKEY:Nursing ProcessStep: m b


Implementation m




MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m




Thechargenurseasksthenewvocationalnurseto start an intravenous infusion, askill that m b m m m m




the vocational nurse has notbeen taught during her educational program. How should
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the vocational nurse respond?
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a. Askamoreexperiencednurseto m m




demonstrate the procedure. m m m




b. Lookuptheprocedureintheprocedure m




manual. m




c. Attempt toperformtheprocedurewith b m




supervision. m




d. Informthechargenurseofherlackof m




training in this procedure. m m m m




ANS: D m




The charge nurse should be informed of the lack of training to perform the procedure, and
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the vocational nurse should seek further training to gain proficiency. Although the other
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options might be helpful, they are not safe.
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PTS: 1 DIF: CognitiveLevel: m 3

, Application REF: m




OBJ: 1 TOP: ProvidingSafeCare NursingProcess
KEY: Step: N/A m m m




MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m




Whichpatientstatementindicatesaneedforfurtherdischargeteachingthatthe vocational
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nurse should address?
m m m




a. “Ihavenoideaofhowthisdrug m




will affect me.” m m m




b. “Doyouknowifmyphysicianis m




coming back today?” m m m




c. “Willmyinsurancepayformy
stay?” m




d. “AmIgoingtohavetogotoa m




nursing home?” m m




ANS: A m




Lack of knowledge at discharge about medication effects and side effects is a concern that
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should be addressed by the vocationalnurse. The other concerns in the options are the
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responsibility of otherdepartments to which the nursemightrefer thepatient.
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Cognitive Level: Application REF:
PTS: 1 DIF: m m




2 m




OBJ:1 TOP: Teaching KEY: Nursing Process m b


Step:Implementation m




MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m




AccordingtomoststateNPAs,thevocationalnurseactingaschargenurseinalong- term care
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facility acts in which capacity?
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a. WorkingunderdirectsupervisionofanRNon the m m m m m m m m




unit m




b. WorkingwiththeRNin thebuilding m m m m m m




c. WorkingundergeneralsupervisionbytheRN m




available on site or by phone
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d. Working as an independent vocational nurse m m m m m




ANS: C m




Thevocationalnurseinthecapacity ofthechargenurseinalong-termcarefacility acts m m m m




mwith the general supervision of an RNavailable on site or by phone.
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PTS: 1
CognitiveLevel: REF: 2 DIF:
Comprehension m




OBJ:1 TOP: ChargeNurse/Manager Nursi Process
KEY: ng Step:N/A m m m




MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m

,Thenurseiseducating apatientthatis amemberofahealth maintenanceorganization m m m m




m(HMO). Which informationshould the nurse include?
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a. Seektheopinionofanalternatehealth care m m m




provider. m




b. Obtaininsuranceapprovalformedical m m




services prior to treatment.
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c. Providedetaileddocumentationofallcare m




received for his condition.
m m m m




d. Waitatleast6months to seeaspecialist. m m m m m m m m




ANS: B m




Most HMOs require preprocedure authorization for treatment. Patients are not required
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to seek a second opinion,providedocumentation of care, or wait a specific time period
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before visiting a specialist.
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CognitiveLevel:
PTS: 1 9 DIF: m




ApplicationREF: m m




OBJ:9 TOP: ChargeNurse/Manager
KEY:NursingProcessStep:Implementation m




MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m




Thepatientcomplainstothenursethatheisconfusedabout his“deductible”that he m m m m




mowes the hospital. Whichstatement accurately explains a deductible?
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a. Anamountofmoneyput asidefor thepaymentof b m




future medical bills m m m




b. Aone-time feefor service m m m m




c. Anamountofmoneydeductedfromthebillby the m




insurance company m m




d. Anannualamountofmoneythepatientmust pay b m




out-of-pocket for medical care
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ANS: D m




Thedeductibleistheannualamounttheinsuredmustpayout-of-pocketpriortothe insurance
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company assuming the cost. This practice improves the profit of the insurance company.
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CognitiveLevel:
PTS: 1 REF: 7 DIF:
Comprehension m




OBJ:9 TOP: HealthCareFinancing m m




KEY:NursingProcessStep:Implementation m




MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care m m m m m




Thenursecomparesthecharacteristicsofahealthmaintenanceorganization(HMO) m m




mand a preferred providerorganization (PPO). Which information should the nurse
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include about HMOs?
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, a. HMOsrequireasetfeeofeach
membermonthly. m m




b. HMOsallowthemembertoselect m




his health care provider.
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c. HMOspermitadmissiontoany
facility the member prefers.
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d. HMOsofferunlimiteddiagnostic
tests and treatments.m m m




ANS: A m




HMOsrequireaset feefromeachmembermonthly(capitation).Thepatientwillbe b m m m m




treatedbytheHMOstaffinHMO-approvedfacilities.Excessiveuseofdiagnostic tests
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and treatments is discouraged by the HMO.
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CognitiveLevel:
PTS: 1 9 DIF: m




ApplicationREF: m m




OBJ:9 TOP: ManagedCare m




KEY:NursingProcessStep:Implementation m




MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care
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Apatient asks the nursewhat Medicare Part A covers. Which response is correct?
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a. MedicarePartAcoversinpatient m m m




hospitalcosts. m




b. Medicare Part A covers m m m




reimbursementtothe physician.
m m m m




c. MedicarePartAcoversoutpatient m m m




hospitalservices. m




d. MedicarePart Acoversambulance m b


transportation. m




ANS: A m




Medicare Part Acoversinpatienthospitalexpenses,drugs,x-rays,laboratorywork,
m b



and intensive care. Medicare Part B pays thephysician, ambulance transport, and
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outpatient services.
m m




CognitiveLevel:
PTS: 1 REF 7,Box DIF:
Comprehension : 1-4 m




OBJ:9 TOP: Government-Sponsored
HealthInsurance m




KEY:NursingProcessStep:Implementation m




MSC:NCLEX: Safe,EffectiveCareEnvironment: Coordinated Care
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Which is the main cost-containment component of diagnosis-related groups (DRGs)?
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